This page provides an overview of California’s Coordinated Care Initiative (CCI). For details about eligibility and enrollment in Cal MediConnect, visit www.calduals.org. Additional resources can be found below.
The State of California enacted the CCI to change the focus and delivery of health care to better serve seniors and persons with disabilities. The goals of the CCI are to:
- Improve quality of care;
- Maximize the ability of seniors and persons with disabilities to remain safely in their homes and communities, with appropriate services and supports;
- Coordinate benefits for persons eligible for both Medicare and Medi-Cal (called dual eligible) and improve continuity of care across health care settings;
- Promote a system that provides seniors and persons with disabilities with timely access to health care and home- and community-based services.
The CCI consists of two main parts:
- Medi-Cal Managed Long-Term Services and Supports (LTSS): LTSS includes In-Home Supportive Services (IHSS), Multipurpose Senior Services Program (MSSP), Community-Based Adult Services (CBAS) and short rehabilitation/long term custodial care in nursing facilities. Nearly all individuals with Medi-Cal (including dual eligibles) must enroll in a Medi-Cal managed care plan to receive their LTSS benefits.
- Cal MediConnect: A voluntary three year pilot project to provide coordinated Medi-Cal and Medicare benefits through a single health plan.
Enrollment in Cal MediConnect in Santa Clara County began in January, 2015. The two Cal MediConnect health plans in Santa Clara County are Anthem Blue Cross and Santa Clara Family Health Plan. Alternatively, individuals age 55 or over who need a higher level of care to live at home may qualify for the Program of All-inclusive Care for the Elderly (PACE), offered by On Lok Lifeways.
Cal MediConnect benefits include:
- Medical care
- Prescription medicines
- Behavioral health care
- LTSS, including IHSS, MSSP, CBAS and nursing home care
- Vision care
- Transportation to medical appointments
- Assistance from a case manager
- 24-hour nurse advice line for help
Case management and care coordination are key benefits of the Cal MediConnect program. Here are some of the ways Cal MediConnect case managers have helped real beneficiaries:
- A daughter struggling with her mother’s dementia was connected to community resources and received help to get IHSS to allow her mother to remain living safely in her own home.
- A woman with respiratory failure and on a ventilator met her goal of returning home for Christmas thanks to her IHSS provider, nursing facility, medical equipment company, and health plan case manager all working together.
Additional Information about Cal MediConnect and the CCI
Santa Clara County regularly offers free general information webinars for beneficiaries and caregivers. Participants may call in on their telephone or watch the presentation on a computer.
To view upcoming webinar dates and register, click on the link below: https://attendee.gotowebinar.com/rt/1828617944709762562
To call in to the webinar in listen-only mode, dial 213-929-4231, and then type in the following access code: 436-086-704. If you want to be able to ask questions during the webinar, you will need to register here in advance.
For questions about the webinar, please contact info@CalDuals.org.
- Contact free, local resources
To make an appointment to get free, unbiased help with your health plan choices, call:
Health Insurance Counseling & Advocacy Program (HICAP)
Hours: 8:00 a.m. to 5:00 p.m., Monday-Friday
For enrollment-specific questions, please contact:
Health Care Options
Hours: 8:00 a.m. to 8:00 p.m., 7 days a week, including holidays
If you are enrolled in Cal MediConnect and have any issues or complaints, call:
Cal MediConnect Ombudsman Program: Bay Area Legal Aid
Hours: 9:00 a.m. to 5:00 p.m., Monday-Friday
To get more information online, visit www.calduals.org.
- Read more and download local factsheets
Cal MediConnect Factsheets: English | Chinese | Spanish | Vietnamese I Korean I Russian I Tagalog
Cal MediConnect Resource Lists: English | Chinese | Spanish | Vietnamese
MLTSS Fact Sheets: English | Chinese | Spanish | Vietnamese
Watch Cal MediConnecToons, a series of animated videos that describe the program, enrollment process, choices available, continuity of care, and beneficiary rights.
Watch this easy to understand, in-depth video about Cal MediConnect.
Anthem Blue Cross - Cal MediConnect Plan
8:00 a.m. - 8:00 p.m., Monday-Friday
Santa Clara Family Health Plan - Cal MediConnect Plan
8:00 a.m. - 8:00 p.m., 7 days a week, including holidays
On Lok Lifeways - PACE Plan
8:00 a.m. – 4:30 p.m., Monday-Friday